JMIR Pediatrics and Parenting最新文献

{"title":"High-Resolution Eye-Tracking System for Accurate Measurement of Short-Latency Ocular Following Responses: Development and Observational Study.","authors":"Aleksandar Miladinović, Christian Quaia, Simone Kresevic, Miloš Ajčević, Laura Diplotti, Paola Michieletto, Agostino Accardo, Stefano Pensiero","doi":"10.2196/64353","DOIUrl":"10.2196/64353","url":null,"abstract":"<p><strong>Background: </strong>Ocular following responses (OFRs)-small-amplitude, short-latency reflexive eye movements-have been used to study visual motion processing, with potential diagnostic applications. However, they are difficult to record with commercial, video-based eye trackers, especially in children.</p><p><strong>Objective: </strong>We aimed to design and develop a noninvasive eye tracker specialized for measuring OFRs, trading off lower temporal resolution and a smaller range for higher spatial resolution.</p><p><strong>Methods: </strong>We developed a high-resolution eye-tracking system based on a high-resolution camera operating in the near-infrared spectral range, coupled with infrared illuminators and a dedicated postprocessing pipeline, optimized to measure OFRs in children. To assess its performance, we: (1) evaluated our algorithm for compensating small head movements in both artificial and real-world settings, (2) compared OFRs measured simultaneously by our system and a reference scleral search coil eye-tracking system, and (3) tested the system's ability to measure OFRs in a clinical setting with children.</p><p><strong>Results: </strong>The simultaneous measurement by our system and a reference system showed that our system achieved an in vivo resolution of approximately 0.06°, which is sufficient for recording OFRs. Head motion compensation was successfully tested, showing a displacement error of less than 5 μm. Finally, robust OFRs were detected in 16 children during recording sessions lasting less than 5 minutes.</p><p><strong>Conclusions: </strong>Our high-resolution, noninvasive eye-tracking system successfully detected OFRs with minimal need for subject cooperation. The system effectively addresses the limits of other OFR measurement methods and offers a versatile solution suitable for clinical applications, particularly in children, where eye tracking is more challenging. The system could potentially be suitable for diagnostic applications, particularly in pediatric populations where early detection of visual disorders like stereodeficiencies is critical.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e64353"},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extent and Nature of Television Food and Nonalcoholic Beverage Marketing in 9 Asian Countries: Cross-Sectional Study Using a Harmonized Approach.","authors":"Tilakavati Karupaiah, Shah Md Mahfuzur Rahman, Juan Zhang, Naveen Kumar, Batjargal Jamiyan, Raj Kumar Pokharel, Elaine Quintana Borazon, Tharanga Thoradeniya, Nguyen Thi Thi Tho, Sally Mackay, Bridget Kelly, Boyd Swinburn, Karuthan Chinna, Enkhmyagmar Dashzeveg, Gild Rick Ong, Sreelakshmi Sankara Narayanan, Mohd Jamil Sameeha, Mohammad Ahsan Uddin, Yuxiang Tang, Naresh Kumar Sharma, Rishav Pokharel, Anna Christine Rome, V Pujitha Wickramasinghe, Phan Thanh Huy","doi":"10.2196/63410","DOIUrl":"10.2196/63410","url":null,"abstract":"<p><strong>Background: </strong>Rising childhood obesity rates in Asia are adding risk for the future adult burden of obesity and noncommunicable diseases. Weak policies across most Asian countries enable unrestricted marketing of obesogenic foods and beverages to children. Television is the common medium for food marketing to reach this audience.</p><p><strong>Objective: </strong>This study aimed to assess the extent and nature of television food and nonalcoholic beverage marketing in 9 Asian countries (Bangladesh, China, India, Malaysia, Mongolia, Nepal, the Philippines, Sri Lanka, and Vietnam) with capacity building support from the International Network for Food and Obesity/Non-Communicable Disease Research, Monitoring and Action Support, who enabled harmonization of data collection method and content analyses.</p><p><strong>Methods: </strong>Advertised foods were categorized as permitted or not permitted based on the nutrient profile models established by the World Health Organization regional offices for South-East Asia (SEARO) and the World Health Organization regional offices for Western Pacific (WPRO). Overall rates of food advertisements (advertisements per hour per channel) and persuasive strategy use were analyzed along with comparisons between children's peak viewing time (PVT) and non-PVT.</p><p><strong>Results: </strong>Cross-country comparisons, irrespective of country income level, indicated that not permitted food advertising dominated children's popular television channels, especially during PVT with rates as per WPRO or SEARO criteria ranging from 2.40/2.29 (Malaysia) to 9.70/9.41 advertisements per hour per channel (the Philippines). Persuasive strategy rates were also comparatively higher during PVT. Sugar-sweetened beverages, sugar-containing solid foods, and high salt- and fat-containing snacks and fast foods were frequently advertised. Evaluation of the application of WPRO and SEARO nutrient profile models identified inconsistencies due to regional taste and cuisine variations across Asia.</p><p><strong>Conclusions: </strong>This study clearly showed that unhealthy food marketing through popular children's television channels is widely occurring in Asia and is a clear breach of child rights. Evidence outcomes will benefit advocacy toward stronger policy regulations to control unhealthy food marketing and strengthen strategies to promote a healthier food environment for Asia's children.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e63410"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Assessment of Postsurgical Pain in Infants at Home Using Artificial Intelligence-Enabled and Observer-Based Tools: Construct Validity and Clinical Utility Evaluation Study.","authors":"Fatos Sada, Paola Chivers, Sokol Cecelia, Sejdi Statovci, Kujtim Ukperaj, Jeffery Hughes, Kreshnik Hoti","doi":"10.2196/64669","DOIUrl":"10.2196/64669","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pain assessment in the infant population is challenging owing to their inability to verbalize and hence self-report pain. Currently, there is a paucity of data on how parents identify and manage this pain at home using standardized pain assessment tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore parents' assessment and intervention of pain in their infants at home following same-day surgery, using standardized pain assessment tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective study initially recruited 109 infant boys undergoing circumcision (same-day surgery). To assess pain at home over 3 days after surgery, parents using iOS devices were assigned to use the PainChek Infant tool, which is a point-of-care artificial intelligence-enabled tool, while parents using Android devices were assigned to use the Observer-Administered Visual Analog Scale (ObsVAS) tool. Chi-square analysis compared the intervention undertaken and pain presence. Generalized estimating equations were used to evaluate outcomes related to construct validity and clinical utility. Receiver operating characteristic analysis assessed pain score cutoffs in relation to the intervention used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 69 parents completed postsurgery pain assessments at home and returned their pain diaries. Of these 69 parents, 24 used ObsVAS and 45 used PainChek Infant. Feeding alone and feeding with medication were the most common pain interventions. Pain presence over time reduced. In the presence of pain, an intervention was likely to be administered (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;2&lt;/sub&gt;=21.4; P&lt;.001), with a medicinal intervention being 12.6 (95% CI 4.3-37.0; P&lt;.001) times more likely and a nonmedicinal intervention being 5.2 (95% CI 1.8-14.6; P=.002) times more likely than no intervention. In the presence of intervention, score cutoff values were ≥2 for PainChek Infant and ≥20 for ObsVAS. A significant effect between the use of the pain instrument (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;1&lt;/sub&gt;=7.2, P=.007) and intervention (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;2&lt;/sub&gt;=43.4, P&lt;.001) was found, supporting the construct validity of both instruments. Standardized pain scores were the highest when a medicinal intervention was undertaken (estimated marginal mean [EMM]=34.2%), followed by a nonmedicinal intervention (EMM=23.5%) and no intervention (EMM=11.2%). Similar trends were seen for both pain instruments. Pain was reduced in 94.5% (224/237) of assessments where parents undertook an intervention. In 75.1% (178/237) of assessments indicative of pain, the score changed from pain to no pain, with PainChek Infant assessments more likely to report this change (odds ratio 4.1, 95% CI 1.4-12.3) compared with ObsVAS assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The use of standardized pain assessment instruments by parents at home to assess pain in their infants can inform their decision-making regarding pain identification and management, including determining t","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e64669"},"PeriodicalIF":2.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities for Telemedicine to Improve Parents' Well-Being During the Neonatal Care Journey: Scoping Review.","authors":"Josephine Wagenaar, Crystal Mah, Fredrik Bodell, Irwin Reiss, Maaike Kleinsmann, Sylvia Obermann-Borst, H Rob Taal","doi":"10.2196/60610","DOIUrl":"10.2196/60610","url":null,"abstract":"<p><strong>Background: </strong>Neonatal intensive care unit admissions of newborns are emotional and stressful for parents, influencing their mental and physical well-being and resulting in high rates of psychological morbidities. Significant research has been undertaken to understand and quantify the burden of a newborn's medical journey on parents' well-being. Simultaneously, an increase has been observed in the development and implementation of telemedicine interventions, defined as the remote delivery of health care. Telemedicine is used as an overarching term for different technological interventions grouped as real-time audio-visual communication, remote patient monitoring, and asynchronous communication. Various telemedicine interventions have been proposed and developed but scarcely with the primary goal of improving parental well-being during their newborn's medical journey.</p><p><strong>Objective: </strong>This study aims to identify telemedicine interventions with the potential to improve parents' well-being and to present the methods used to measure their experience.</p><p><strong>Methods: </strong>A scoping review was conducted, including empirical studies evaluating telemedicine in neonatal care that either measured parental well-being or included parents in the evaluation. Abstract and title screening, full-text screening, and data extraction were performed by three researchers. Two researchers were needed to reach decisions on both the inclusion and extraction of articles.</p><p><strong>Results: </strong>The review included 50 out of 737 screened articles. Telemedicine interventions focused mainly on daily visits at the neonatal intensive care unit and discharge preparedness for parents. Surveys were the primary tool used for outcome measurement (36/50, 72%). Aspects of parents' well-being were evaluated in 62% (31/50) of studies. Telemedicine interventions developed to provide education and support showed a potential to improve self-efficacy and discharge preparedness and decrease anxiety and stress when they included a real-time telemedicine component.</p><p><strong>Conclusions: </strong>This scoping review identified specific telemedicine interventions, such as real-time audio-visual communication and eHealth apps, that have the potential to improve parental well-being by enhancing self-efficacy and discharge preparedness, and reducing anxiety and stress. However, more insights are needed to understand how these interventions affect well-being. Parents should be included in future research in both the development and evaluation stages. It is important to not only measure parents' perceptions but also focus on the impact of a telemedicine intervention on their well-being.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e60610"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous Parents' Perspectives of Factors That Facilitate or Impede Engagement in Internet-Based Parenting Support Programs: Interpretive Description Study.","authors":"Michelle L Butt, Ysabella Jayne Willett, Vicky Miller, Brenda Jacobs, Era Mae Ferron, Amy L Wright","doi":"10.2196/64994","DOIUrl":"10.2196/64994","url":null,"abstract":"<p><strong>Background: </strong>Parenting support programs enhance parents' health and their child's development. The COVID-19 pandemic necessitated the delivery of these programs over the internet. After the pandemic, internet-based programs are still preferred by some.</p><p><strong>Objective: </strong>We aimed to understand Indigenous parents' experiences engaging in internet-based parenting support programs; thus, an interpretive description study was conducted.</p><p><strong>Methods: </strong>A total of 20 Indigenous (female, male, and Two-Spirit) parents of children aged <5 years participated in semistructured interviews; data underwent collaborative thematic analysis with Indigenous community partners informed by the Two-Eyed Seeing framework and ethical space.</p><p><strong>Results: </strong>Parents' experiences were classified into five themes: (1) Purpose: Program Delivery and Content, (2) Belonging: Building Relationships and Connections, (3) Hope: Cultural Connection, (4) Meaning: New or Improved Parenting Skills and Mental Wellness, and (5) Recommendations for Organizations.</p><p><strong>Conclusions: </strong>The study findings can inform internet-based parenting program delivery to enhance engagement for Indigenous families.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e64994"},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Use of a Length AI Algorithm to Estimate Children's Length from Smartphone Images in a Real-World Setting: Algorithm Development and Usability Study.","authors":"Mei Chien Chua, Matthew Hadimaja, Jill Wong, Sankha Subhra Mukherjee, Agathe Foussat, Daniel Chan, Umesh Nandal, Fabian Yap","doi":"10.2196/59564","DOIUrl":"10.2196/59564","url":null,"abstract":"<p><strong>Background: </strong>Length measurement in young children younger than 18 months is important for monitoring growth and development. Accurate length measurement requires proper equipment, standardized methods, and trained personnel. In addition, length measurement requires young children's cooperation, making it particularly challenging during infancy and toddlerhood.</p><p><strong>Objective: </strong>This study aimed to develop a length artificial intelligence (LAI) algorithm to aid users in determining recumbent length conveniently from smartphone images and explore its performance and suitability for personal and clinical use.</p><p><strong>Methods: </strong>This proof-of-concept study in healthy children (aged 0-18 months) was performed at KK Women's and Children's Hospital, Singapore, from November 2021 to March 2022. Smartphone images were taken by parents and investigators. Standardized length-board measurements were taken by trained investigators. Performance was evaluated by comparing the tool's image-based length estimations with length-board measurements (bias [mean error, mean difference between measured and predicted length]; absolute error [magnitude of error]). Prediction performance was evaluated on an individual-image basis and participant-averaged basis. User experience was collected through questionnaires.</p><p><strong>Results: </strong>A total of 215 participants (median age 4.4, IQR 1.9-9.7 months) were included. The tool produced a length prediction for 99.4% (2211/2224) of photos analyzed. The mean absolute error was 2.47 cm for individual image predictions and 1.77 cm for participant-averaged predictions. Investigators and parents reported no difficulties in capturing the required photos for most participants (182/215, 84.7% participants and 144/200, 72% participants, respectively).</p><p><strong>Conclusions: </strong>The LAI algorithm is an accessible and novel way of estimating children's length from smartphone images without the need for specialized equipment or trained personnel. The LAI algorithm's current performance and ease of use suggest its potential for use by parents or caregivers with an accuracy approaching what is typically achieved in general clinics or community health settings. The results show that the algorithm is acceptable for use in a personal setting, serving as a proof of concept for use in clinical settings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05079776; https://clinicaltrials.gov/ct2/show/NCT05079776.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e59564"},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cocreating First Steps, a Toolkit to Improve Adolescent Sexual and Reproductive Health Services: Qualitative Human-Centered Design Study With Hispanic and Black Adolescent Mothers in New York City.","authors":"Lauren Gerchow, Yzette Lanier, Anne-Laure Fayard, Allison Squires","doi":"10.2196/60692","DOIUrl":"10.2196/60692","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescent voices are frequently excluded from sexual and reproductive health (SRH) research. Despite progressive policies and access to SRH care, adolescents in New York City who live in neighborhoods with high poverty and those who identify as Black or Hispanic experience poor SRH outcomes, including high rates of unplanned pregnancies and sexually transmitted infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This qualitative study aims to guide Black and Hispanic adolescent mothers in identifying problem areas in SRH care and cocreate health service recommendations with input from health care stakeholders to address those problems and improve SRH experiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Through ethnographic interview methods, adolescent mothers in New York City shared their experiences from before pregnancy through parenting and identified problem areas in adolescent SRH services and education. Data were analyzed inductively and using situational analysis. Adolescent participants attended 2 cocreation workshops. In the first workshop, they confirmed interview findings, set priorities, and created rough prototypes. Following the first workshop, health care providers were interviewed to inform refinement of the rough prototypes. Adolescents further developed prototypes in the second cocreation workshop and named the resulting toolkit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 16 adolescent mothers participated in 47 interviews, and 10 (63%) participants attended at least 1 cocreation workshop. They highlighted deficiencies in sexual health education and emphasized the roles of health care providers and parents, rather than schools, in improving it. Adolescent participants designed recommendations for adolescents and health care providers to support quality conversations between adolescents, parents, and health care providers and created a preappointment checklist to help young patients initiate conversations with health care providers. Young participants stressed that sex education should address topics beyond sexually transmitted infections and pregnancy, such as emotional health and relationships. They created guidelines for health care providers outlining communication strategies to provide respectful, unbiased care and contraceptive counseling that encourages adolescent autonomy. Participants shared specific suggestions for how to support young parents respectfully. Health care stakeholders recommended adding information on confidential care; supporting lesbian, gay, bisexual, transgender, and queer youth; and focusing on improving communication between health care providers and patients rather than creating educational materials. In the second workshop, adolescent participants revised the prototypes based on feedback from health care stakeholders and named the toolkit of recommendations First Steps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study highlighted the important roles that parents and health care wo","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e60692"},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Online Resource for Monitoring 24-Hour Activity in Children and Adolescents: Observational Analysis.","authors":"Benny Kai Guo Loo, Siao Hui Toh, Fadzlynn Fadzully, Mohammad Ashik Zainuddin, Muhammad Alif Abu Bakar, Joanne Shumin Gao, Jing Chun Teo, Ethel Jie Kai Lim, Beron Wei Zhong Tan, Michael Yong Hwa Chia, Terence Buan Kiong Chua, Kok Hian Tan","doi":"10.2196/59283","DOIUrl":"10.2196/59283","url":null,"abstract":"<p><strong>Background: </strong>The Singapore integrated 24-hour activity guide for children and adolescents was introduced to promote healthy lifestyle behaviors, including physical activity, sedentary behavior, sleep, and diet, to enhance metabolic health and prevent noncommunicable diseases. To support the dissemination and implementation of these recommendations, a user-friendly online resource was created to help children and adolescents adopt these behaviors in Singapore.</p><p><strong>Objective: </strong>This study aimed to assess the acceptability of the online resource in the adoption of healthier lifestyle behaviors, and the change in the users' behaviors with the use of this online resource.</p><p><strong>Methods: </strong>Participants aged 7-17 years were required to log their activity levels of the past 7 days at the beginning and at the end of a 3-month period using the browser-based online resource, including information on the duration and frequency of moderate- to vigorous-intensity physical activity (MVPA), length of sedentary behavior, duration and regularity of sleep, and food portions. User satisfaction, on the length, ease of use, and relevance of the online resource, was also recorded using a 10-point Likert scale. Descriptive statistics and statistical analyses, including the Wilcoxon signed rank test and McNemar test, were carried out at baseline and at the end of 3 months.</p><p><strong>Results: </strong>A total of 46 participants were included for analysis. For physical activity, the number of days of MVPA increased from a median of 3 (IQR 2-5) days to 4 (IQR 2-5) days (P=.01). For sedentary behavior, the median daily average screen time decreased from 106 (IQR 60-142.5) minutes to 90 (IQR 60-185) minutes. For sleep, 10% (5/46) more participants met the recommended duration, and the number of days with regular sleep increased from a median of 6 (IQR 5-7) days to 7 (IQR 5-7) days (P=.03). For diet, there was a decrease in the portion of carbohydrates consumed from a median of 42% (IQR 30-50) to 40% (IQR 30-48.5; P=.03), and the number of days of water and unsweetened beverage consumption remained stable at a median of 5 days but with a higher IQR of 4-7 days (P=.04). About 90% (39-41/46) of the participants reported that the online resource was relevant and easy to use, and the rating for user satisfaction remained favorable at a median of 8 with a higher IQR of 7-9 (P=.005).</p><p><strong>Conclusions: </strong>The findings support the development of a dedicated online resource to assist the implementation of healthy lifestyle behaviors based on the Singapore integrated 24-hour activity guide for children and adolescents. This resource received favorable ratings and its use showed the adoption of healthier behaviors, including increased physical activity and sleep, as well as decreased sedentary time and carbohydrate consumption, at the end of a 3-month period.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e59283"},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Refinement of a Chatbot for Birthing Individuals and Newborn Caregivers: Mixed Methods Study.","authors":"Jessica Nathalie Rivera Rivera, Katarina E AuBuchon, Marjanna Smith, Claire Starling, Karen G Ganacias, Aimee Danielson, Loral Patchen, Janine A Rethy, H Joseph Blumenthal, Angela D Thomas, Hannah Arem","doi":"10.2196/56807","DOIUrl":"10.2196/56807","url":null,"abstract":"<p><strong>Background: </strong>The 42 days after delivery (\"fourth trimester\") are a high-risk period for birthing individuals and newborns, especially those who are racially and ethnically marginalized due to structural racism.</p><p><strong>Objective: </strong>To fill a gap in the critical \"fourth trimester,\" we developed 2 ruled-based chatbots-one for birthing individuals and one for newborn caregivers-that provided trusted information about postbirth warning signs and newborn care and connected patients with health care providers.</p><p><strong>Methods: </strong>A total of 4370 individuals received the newborn chatbot outreach between September 1, 2022, and December 31, 2023, and 3497 individuals received the postpartum chatbot outreach between November 16, 2022, and December 31, 2023. We conducted surveys and interviews in English and Spanish to understand the acceptability and usability of the chatbot and identify areas for improvement. We sampled from hospital discharge lists that distributed the chatbot, stratified by prenatal care location, age, type of insurance, and racial and ethnic group. We analyzed quantitative results using descriptive analyses in SPSS (IBM Corp) and qualitative results using deductive coding in Dedoose (SocioCultural Research Consultants).</p><p><strong>Results: </strong>Overall, 2748 (63%) individuals opened the newborn chatbot messaging, and 2244 (64%) individuals opened the postpartum chatbot messaging. A total of 100 patients engaged with the chatbot and provided survey feedback; of those, 40% (n=40) identified as Black, 27% (n=27) identified as Hispanic/Latina, and 18% (n=18) completed the survey in Spanish. Payer distribution was 55% (n=55) for individuals with public insurance, 39% (n=39) for those with commercial insurance, and 2% (n=2) for uninsured individuals. The majority of surveyed participants indicated that chatbot messaging was timely and easy to use (n=80, 80%) and found the reminders to schedule the newborn visit (n=59, 59%) and postpartum visit (n=66, 66%) useful. Across 23 interviews (n=14, 61% Black; n=4, 17% Hispanic/Latina; n=2, 9% in Spanish; n=11, 48% public insurance), 78% (n=18) of interviewees engaged with the chatbot. Interviewees provided positive feedback on usability and content and recommendations for improving the outreach messages.</p><p><strong>Conclusions: </strong>Chatbots are a promising strategy to reach birthing individuals and newborn caregivers with information about postpartum recovery and newborn care, but intentional outreach and engagement strategies are needed to optimize interaction. Future work should measure the chatbot's impact on health outcomes and reduce disparities.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e56807"},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Feasibility and Acceptability of Technological Interventions to Prevent Adolescents' Exposure to Online Pornography: Qualitative Research.","authors":"Jake Turvey, Dana McKay, Sarah T Kaur, Natasha Castree, Shanton Chang, Megan S C Lim","doi":"10.2196/58684","DOIUrl":"10.2196/58684","url":null,"abstract":"<p><strong>Background: </strong>Amid growing concern over children's access to online pornography, policy makers are looking toward new and emerging technological concepts for unexplored solutions including artificial intelligence and facial recognition.</p><p><strong>Objective: </strong>This study sought to explore and ideate emerging technological interventions that are feasible, acceptable, and effective in preventing and controlling the exposure of young people to online pornographic material.</p><p><strong>Methods: </strong>We conducted a series of qualitative co-design workshops with both adult (n=8; aged 32-53 years) and adolescent participants (n=4; aged 15-17 years) to ideate potential technological interventions that are feasible, acceptable, and effective at preventing and controlling the exposure of young people to online pornographic material. A story stem methodology was used to explore participants' attitudes toward two unique technological prototypes.</p><p><strong>Results: </strong>Participants expressed a generally favorable view of the proposed technological concepts but remained unconvinced of their overall utility and effectiveness in preventing the intentional viewing of pornography by young people. Age-appropriate parent-child conversations remained participants' preferred approach to mitigating potential harms from pornographic material, with parents also expressing a desire for more educational resources to help them better navigate these discussions. User privacy and data security were a primary concern for participants, particularly surrounding the use and collection of biometric data.</p><p><strong>Conclusions: </strong>Internationally, policy makers are taking action to use age assurance technologies to prevent children's access to online pornography. It is important to consider the needs and opinions of parents and young people in the use and implementation of these technologies. Participants in this study were generally supportive of new and emerging technologies as useful tools in preventing the accidental exposure of young people to online pornographic material. However, participants remained less convinced of their ability to avert intentional viewing, with substantial concerns regarding technological efficacy, adaptability, and user privacy. Further, co-design and prototype refinement are needed to better understand user acceptability and comfortability of these new technological interventions, alongside additional research exploring sociocultural differences in information needs and user experiences.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e58684"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}